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Study to Assess Various Sunitinib Schedules in Renal Cell Carcinoma (SURF)

Primary Purpose

Kidney Neoplasms, Metastatic Renal Cell Cancer

Status
Active
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Sunitinib
Sponsored by
Centre Hospitalier Universitaire de Besancon
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Kidney Neoplasms focused on measuring renal cell carcinoma, sunitinib, metastatic, schedule, toxicity, safety

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • Men or women over 18 years old
  • Patients with local, advanced or inoperable or metastatic (MRCC) renal cell carcinoma who are starting first line treatment with Sunitinib 50mg (4/6 regimen) according to the Marketing Authorisation Indication
  • Patients with histologically or cytologically confirmed renal cancer, clear cell variant or with a clear cell component
  • Karnofsky performance status ≥ 70%
  • Adequate organ function:

    • Absolute neutrophil (N) count ≥ 1 500 / µL
    • Platelets ≥ 100 000 / µL
    • Haemoglobin ≥ 10 g/dL
    • Adjusted serum calcium ≤ 2.6 mmol/L
    • Creatinine clearance ≥ 30 mL/min (by the MDRD formula)
    • Total bilirubin ≤ 1.5 x ULN (upper limit of the normal range)
    • AST ≤ 2.5 x ULN and ALT ≤ 2.5 x ULN OR AST and ALT ≤ 5 x ULN if liver abnormalities due to liver metastases AST = aspartate aminotransferase ALT = alanine aminotransferase

Key Exclusion Criteria:

  • Renal carcinoma with no clear cell component.
  • Previous systemic treatment for the RCC regardless of type (including targeted therapy, immunotherapy, chemotherapy, hormone or experimental therapy). Previous or concomitant treatment with a bisphosphonate or denosumab is allowed.
  • Patients whose clinical state and comorbidities are not consistent with administration of Sunitinib at the initial dose of 50mg/day 4 weeks out of 6.
  • Grade 3 haemorrhage within 4 weeks before starting treatment with Sunitinib (according to the NCI-CTCAE toxicity score version 3.0).
  • The presence of a past history of cancer in the 3 years before inclusion into the study
  • Major surgery within 4 weeks before sunitinib initiation
  • Past history of symptomatic cerebral metastases, spinal cord compression or meningeal carcinomatosis. Patients with cerebral metastases discovered incidentally on imaging and who are asymptomatic are not excluded if these metastases have been treated (radiotherapy and/or surgery) with a period of at least 4 weeks between the end of treatment and inclusion into the study and no clinical or radiological signs of relapse, and corticosteroid dose is not exceeding 10mg/day of prednisone or equivalent. Subjects will be excluded if subjects have signs of grade ≥ 2 treatment-related complications.
  • Any of the following features within 6 months of the administration of Sunitinib: myocardial infarction, severe/unstable angina, coronary artery/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack.
  • Pulmonary embolism or deep vein thrombosis within 3 months of inclusion (unless it's stable, asymptomatic and treated with a low molecular weight heparin for at least 6 weeks before inclusion).
  • Any known acute or chronic disorder (such as severe chronic obstructive pulmonary disease) which in the opinion of the investigator could impact on the patient's capacity to receive the study treatment or make interpretation of toxicity or adverse events difficult.
  • Known HIV infection.
  • History of chronic active hepatitis including subjects who are carriers of the hepatitis B (HBV) or hepatitis C (HCV) virus.
  • Existence of uncontrolled infection.
  • Uncontrolled hypertension defined as a blood pressure of > 150 mmHg systolic or > 100 mmHg diastolic despite optimal anti-hypertensive therapy (blood pressure must be controlled at inclusion).

Sites / Locations

  • CHU Besancon

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Arm A 4/6

Arm B 2/3

Arm Description

Sunitinib 37.5 mg/day; regimen 4/6 (Marketing Authorisation Indication) 4 weeks "on " alternating with 2 weeks "off "

Sunitinib 50 mg/day; regimen 2/3 (experimental arm) 2 weeks "on " alternating with 1 week "off "

Outcomes

Primary Outcome Measures

MDT (median duration of treatment)
The primary objective of this study is to estimate the median duration of treatment in each treatment group (arm A vs arm B) calculated from sunitinib initiation.

Secondary Outcome Measures

PFS (progression-free survival)
To estimate progression-free survival in patients included in each of the groups and in the overall population included in this study.
OS (overall survival)
To estimate overall survival in patients included in each of the groups and in the overall population included in this study.
duration of sunitinib post randomization
Estimation of the time between date of randomization and sunitinib arrest (for any reason) in the two treatment arms.
time to randomization
To estimate the time to randomization defined as the time between the date of sunitinib initiation and the date of randomization.
ORR (objective response rate)
To measure the objective response rate according to RECIST 1.1 criteria.
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
To assess safety profile before and after randomization.
QOL (quality of life)
To assess health-related quality of life since sunitinib is started (before randomization, at the time of randomization and after randomization)

Full Information

First Posted
February 10, 2016
Last Updated
November 17, 2021
Sponsor
Centre Hospitalier Universitaire de Besancon
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT02689167
Brief Title
Study to Assess Various Sunitinib Schedules in Renal Cell Carcinoma
Acronym
SURF
Official Title
Open Label, Randomised Multi-centre Phase II Study to Assess the Efficacy and Tolerability of Sunitinib by Dose Administration Regimen (Dose Modification or Dose Interruptions) in Patients With Advanced or Metastatic Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 19, 2016 (Actual)
Primary Completion Date
February 2024 (Anticipated)
Study Completion Date
February 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Hospitalier Universitaire de Besancon
Collaborators
Pfizer

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Patients who are candidates for first line treatment with Sunitinib 50mg 4/6 regimen in accordance with the Marketing Authorisation who meet the inclusion/exclusion criteria will be offered participation in this study during the consultation as part of their usual care. The patients will be included before Sunitinib treatment is started. Thereafter, sunitinib is initiated 50 mg/day; regimen 4/6 (Marketing Authorisation Indication), 4 weeks "on " alternating with 2 weeks "off " As soon as a dose or schedule adjustment is required, regardless of cause, the patient will be randomised 1/1: Either into arm A and will receive 37.5mg of Sunitinib per day by the 4/6 regimen (in accordance with the Marketing Authorisation); 4 weeks "on " alternating with 2 weeks "off " Or into arm B and will receive 50mg of Sunitinib per day by the 2/3 regimen (investigational arm); 2 weeks "on " alternating with 1 week "off "

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Neoplasms, Metastatic Renal Cell Cancer
Keywords
renal cell carcinoma, sunitinib, metastatic, schedule, toxicity, safety

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
226 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A 4/6
Arm Type
Active Comparator
Arm Description
Sunitinib 37.5 mg/day; regimen 4/6 (Marketing Authorisation Indication) 4 weeks "on " alternating with 2 weeks "off "
Arm Title
Arm B 2/3
Arm Type
Experimental
Arm Description
Sunitinib 50 mg/day; regimen 2/3 (experimental arm) 2 weeks "on " alternating with 1 week "off "
Intervention Type
Drug
Intervention Name(s)
Sunitinib
Primary Outcome Measure Information:
Title
MDT (median duration of treatment)
Description
The primary objective of this study is to estimate the median duration of treatment in each treatment group (arm A vs arm B) calculated from sunitinib initiation.
Time Frame
12 mo
Secondary Outcome Measure Information:
Title
PFS (progression-free survival)
Description
To estimate progression-free survival in patients included in each of the groups and in the overall population included in this study.
Time Frame
12 months
Title
OS (overall survival)
Description
To estimate overall survival in patients included in each of the groups and in the overall population included in this study.
Time Frame
30 months
Title
duration of sunitinib post randomization
Description
Estimation of the time between date of randomization and sunitinib arrest (for any reason) in the two treatment arms.
Time Frame
12 months
Title
time to randomization
Description
To estimate the time to randomization defined as the time between the date of sunitinib initiation and the date of randomization.
Time Frame
4 months
Title
ORR (objective response rate)
Description
To measure the objective response rate according to RECIST 1.1 criteria.
Time Frame
6 months
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
To assess safety profile before and after randomization.
Time Frame
24 months
Title
QOL (quality of life)
Description
To assess health-related quality of life since sunitinib is started (before randomization, at the time of randomization and after randomization)
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Men or women over 18 years old Patients with local, advanced or inoperable or metastatic (MRCC) renal cell carcinoma who are starting first line treatment with Sunitinib 50mg (4/6 regimen) according to the Marketing Authorisation Indication Patients with histologically or cytologically confirmed renal cancer, clear cell variant or with a clear cell component Karnofsky performance status ≥ 70% Adequate organ function: Absolute neutrophil (N) count ≥ 1 500 / µL Platelets ≥ 100 000 / µL Haemoglobin ≥ 10 g/dL Adjusted serum calcium ≤ 2.6 mmol/L Creatinine clearance ≥ 30 mL/min (by the MDRD formula) Total bilirubin ≤ 1.5 x ULN (upper limit of the normal range) AST ≤ 2.5 x ULN and ALT ≤ 2.5 x ULN OR AST and ALT ≤ 5 x ULN if liver abnormalities due to liver metastases AST = aspartate aminotransferase ALT = alanine aminotransferase Key Exclusion Criteria: Renal carcinoma with no clear cell component. Previous systemic treatment for the RCC regardless of type (including targeted therapy, immunotherapy, chemotherapy, hormone or experimental therapy). Previous or concomitant treatment with a bisphosphonate or denosumab is allowed. Patients whose clinical state and comorbidities are not consistent with administration of Sunitinib at the initial dose of 50mg/day 4 weeks out of 6. Grade 3 haemorrhage within 4 weeks before starting treatment with Sunitinib (according to the NCI-CTCAE toxicity score version 3.0). The presence of a past history of cancer in the 3 years before inclusion into the study Major surgery within 4 weeks before sunitinib initiation Past history of symptomatic cerebral metastases, spinal cord compression or meningeal carcinomatosis. Patients with cerebral metastases discovered incidentally on imaging and who are asymptomatic are not excluded if these metastases have been treated (radiotherapy and/or surgery) with a period of at least 4 weeks between the end of treatment and inclusion into the study and no clinical or radiological signs of relapse, and corticosteroid dose is not exceeding 10mg/day of prednisone or equivalent. Subjects will be excluded if subjects have signs of grade ≥ 2 treatment-related complications. Any of the following features within 6 months of the administration of Sunitinib: myocardial infarction, severe/unstable angina, coronary artery/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack. Pulmonary embolism or deep vein thrombosis within 3 months of inclusion (unless it's stable, asymptomatic and treated with a low molecular weight heparin for at least 6 weeks before inclusion). Any known acute or chronic disorder (such as severe chronic obstructive pulmonary disease) which in the opinion of the investigator could impact on the patient's capacity to receive the study treatment or make interpretation of toxicity or adverse events difficult. Known HIV infection. History of chronic active hepatitis including subjects who are carriers of the hepatitis B (HBV) or hepatitis C (HCV) virus. Existence of uncontrolled infection. Uncontrolled hypertension defined as a blood pressure of > 150 mmHg systolic or > 100 mmHg diastolic despite optimal anti-hypertensive therapy (blood pressure must be controlled at inclusion).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
antoine thiery-vuillemin, MD PhD
Organizational Affiliation
Centre Hospitalier Universitaire de Besancon
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU Besancon
City
Besancon
State/Province
Franche-Comté
ZIP/Postal Code
25030
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

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Study to Assess Various Sunitinib Schedules in Renal Cell Carcinoma

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